Ring T, Sattler R W
Abteilung für Allgemein- und Unfallchirurgie, Kreiskrankenhaus Soltau.
Unfallchirurgie. 1998 Feb;24(1):32-7.
Patients who suffer an accident after alcohol consumption can be differentiated into 2 groups: patients which drink alcohol occasionally and chronic alcoholics. We examined prospectively in-patients treated after suffering a trauma in an alcoholised state. The diagnosis acute alcohol intoxication was made by a breath-alcohol-analysis, the diagnosis chronic alcoholism by a shortened MAST-test. In the average chronic alcoholics were 12 years older than acute intoxicated. Family background of chronic alcoholics was more often disrupted and social status lower than in acute alcoholics. For the acute alcoholics a car crash, for the chronic alcoholics a fall was the main trauma cause. In over 50% both patient groups suffered a minor head injury. Chronic alcoholics had a twice as long hospital stay (16.1 +/- 3.2 vs. 8.5 +/- 1.1 days), needed more specialist consultations (84% vs. 60%) and developed more complications (40% vs 16%) than the acute alcohol intoxicated. The ISS (Injury Severity Score) was the same for both patient groups (6.7 +/- 0.7 vs. 7.1 +/- 0.8) and had no prognostic value for the group of the chronic alcoholics. On the basis of the present findings it is advisable to check the diagnosis alcohol intoxication and to look whether chronic alcoholism is present whenever a drunken patient is admitted.
偶尔饮酒的患者和慢性酗酒者。我们对在酒精影响状态下遭受创伤后接受治疗的住院患者进行了前瞻性研究。急性酒精中毒的诊断通过呼气酒精分析进行，慢性酒精中毒的诊断通过缩短版的密歇根酒精中毒筛查测试（MAST-test）进行。平均而言，慢性酗酒者比急性中毒者大12岁。慢性酗酒者的家庭背景更常破裂，社会地位比急性酗酒者低。对于急性酗酒者，车祸是主要创伤原因；对于慢性酗酒者，跌倒则是主要创伤原因。超过50%的两组患者都遭受了轻度头部损伤。与急性酒精中毒者相比，慢性酗酒者的住院时间延长了一倍（16.1±3.2天对8.5±1.1天），需要更多专科会诊（84%对60%），并发更多并发症（40%对16%）。两组患者的损伤严重度评分（ISS）相同（6.7±0.7对7.1±0.8），且对慢性酗酒者组无预后价值。基于目前的研究结果，建议在收治醉酒患者时检查酒精中毒诊断，并查看是否存在慢性酗酒情况。
